肝硬化门脉高压症并发血栓形成机制和治疗研究进展  

Mechanism of portal vein thrombosis in cirrhotic patients with portal hypertension and the treatment

作　　者：张瑞 王剑 陈世耀 Zhang Rui;Wang Jian;Chen Shiyao(Department of Gastroenterology and Hepatology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院消化科

出　　处：《实用肝脏病杂志》2019年第6期930-933,共4页Journal of Practical Hepatology

基　　金：上海市科学技术委员会创新科技项目(编号:15411950501/15411950507);上海市科学技术委员会科研计划项目(编号:17140902700)

摘　　要：肝硬化门脉高压症并发血栓是临床研究实践过程中面临的难题。本文通过对其形成机制和治疗相关研究进展进行总结,重点介绍了近年来国内外关于肝硬化门脉高压并发门脉血栓发生机制和治疗进展。目前认识的主要发生机制包括肝星状细胞的活性、内皮细胞的功能、机体促凝血和凝血抑制失衡等,治疗措施包括低分子肝素等抗凝治疗、β受体阻滞剂和其他药物,如辛伐他汀、利福昔明和益生菌等联合应用以降低门脉压力治疗、提高一氧化氮合成酶磷酸化水平和针对线粒体的抗氧化治疗等措施。The portal thrombosis in cirrhotic patients with portal hypertension is a difficult problem in clinical practice.In this review,we made a summary about studies related on its pathological mechanism and treatment of portal vein thrombosis in patients with portal hypertension.At present,the mechanisms are mainly involving the activities of hepatic stellate cells,endothelial cell functions and the imbalance between pro-coagulation and anticoagulation.For the treatment,it consists of anticoagulant therapy,such as low molecular weight heparin,reducing portal vein pressure,like the combination ofβ-blockers with other medicines,simvastatin,rifaximin and probiotics,for instance,the increase of eNOS phosphorylation,and antioxidant therapy for mitochondria.

关 键 词：门脉高压 门脉血栓 发病机制 治疗 

分 类 号：R54[医药卫生—心血管疾病]